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Case management and vouchers improve uptake of methadone treatment programmes

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 Q Does the use of case management and/or vouchers for free methadone maintenance treatment encourage people abusing opioids to enroll in drug abuse treatment programmes?

METHODS

Embedded ImageDesign:

Randomised controlled trial.

Embedded ImageAllocation:

Concealed.

Embedded ImageBlinding:

Unblinded.

Embedded ImageFollow up period:

6 months.

Embedded ImageSetting:

San Francisco General Hospital, USA; recruitment June 2000 to October 2002.

Embedded ImagePatients:

126 people aged 18–65 years currently using heroin (average age 43 years; 77% men; 83% homeless; average of 18 years of heroin use). Exclusions: <2 years of heroin dependence; <2 prior treatment attempts; using heroin <15 days a month; psychosis; other serious medical problems; intoxicated, sedated or asleep; in police custody or awaiting incarceration; already scheduled for case management or drug abuse treatment; leaving the area within 6 months; or already participating in a research study.

Embedded ImageIntervention:

Case management, vouchers, case management plus vouchers, or usual care. Case management: participants assigned a case manager who facilitated substance abuse treatment, and medical and social services. Vouchers: participants received vouchers for methadone treatment, monthly drug testing, …

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